EVALUATION OF THE PREEMPTIVE ANALGESIC EFFICACY OF ULTRASOUND GUIDED QUADRATUS LUMBORUM BLOCK IN NEPHRECTOMY

Document Type : Original Article

Authors

Department of Anesthesia & Intensive Care and Pain Management, Faculty of Medicine - Ain Shams University, Cairo, Egypt.

Abstract

Background: Nephrectomy is a particularly painful procedure especially the open type rather than the laparoscopic type. There are multiple techniques for postoperative pain management after nephrectomy; opioid therapy, neuraxial analgesia and Quadratus lumborum block.
Aim of the study: to evaluate the preemptive analgesic efficacy of ultrasound guided lateral quadratus lumborum block during the intraoperative period of nephrectomy regarding opioids sparing effect and at the early postoperative period regarding pain relief, early mobilization and opioids sparing effect.
Patients and Methods: This study included forty patients aging 18-65 years old, admitted to operating room in Ain Shams University hospitals for elective open and simple nephrectomy. The patients were divided into two equal groups, Group 1: The patients received general anesthesia with conventional pain management by intravenous opioids, Group 2: received preoperative unilateral ultrasound guided quadratus lumborum block using 0.4 ml/kg bupivacaine 0.25% combined with general anesthesia.
Results: The current study showed significant decrease of the opioid consumption in the patients of the quadratus lumborum block group in both the intraoperative and postoperative periods with less pain score compared to the patients of the opioid group.
Conclusion: Our results showed that the ultrasound guided quadratus lumborum block was an effective technique in providing preemptive analgesia in patients undergoing nephrectomy surgery. The patients who received QLB required less intraoperative and postoperative analgesic requirements, as well as postoperative rescue analgesia.

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